[Federal Register Volume 84, Number 157 (Wednesday, August 14, 2019)]
[Notices]
[Pages 40467-40469]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-17359]


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SOCIAL SECURITY ADMINISTRATION

[Docket No. SSA-2018-0051]


Social Security Ruling 19-3p; Titles II and XVI: Requesting 
Reconsideration or Hearing by an Administrative Law Judge

AGENCY: Social Security Administration.

ACTION: Notice of Social Security Ruling (SSR).

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SUMMARY: We are giving notice of SSR 19-3p. This SSR explains the two 
options available to claimants appealing our determinations that they 
are not disabled based on medical factors. In this SSR, we explain both 
the paper and electronic appeal options for requesting reconsideration 
or a hearing by an administrative law judge (ALJ), and the similarities 
and differences between these two options. We explain these options to 
help claimants make informed decisions when deciding whether to use the 
paper appeal or electronic appeal option to request reconsideration or 
a hearing.

DATES: We will apply this notice on August 14, 2019.

FOR FURTHER INFORMATION CONTACT: Alicia Wood-Smith, Office of Income 
Security Programs, Social Security Administration, 6401 Security 
Boulevard, Baltimore, MD 21235-6401, 410-965-9243. For information on 
eligibility or filing for benefits, call our national toll-free number 
1-800-772-1213, or TTY 1-800-325-0778, or visit our internet site, 
Social Security online, at http://www.socialsecurity.gov.

SUPPLEMENTARY INFORMATION: Through SSRs, we make available to the 
public precedential decisions relating to the Federal old-age, 
survivors, disability, supplemental security income, and special 
veterans benefits programs. We may base SSRs on determinations or 
decisions made at all levels of administrative adjudication, Federal 
court decisions, Commissioner's decisions, opinions of the Office of 
the General Counsel, or other interpretations of the law and 
regulations.
    This SSR explains that to use the electronic appeal option to 
request reconsideration or a hearing, claimants must submit all of the 
information we need to process their appeals at the time they file 
their electronic appeals. This is required only in our streamlined 
electronic appeal procedures. Our manually submitted paper appeal 
procedures remain unchanged. Claimants can upload and submit evidence 
simultaneously with their electronic appeals. After claimants have 
filed their appeals, they can submit evidence by fax, by mail, or in-
person at one of our field offices or hearing offices as appropriate. A 
claimant has an ongoing duty to inform us about or submit all known 
evidence that relates to whether or not he or she is blind or 
disabled.\1\ An appointed representative must act with reasonable 
promptness to help obtain the information and evidence the claimant 
must submit, and forward the information or evidence to us as soon as 
practicable.\2\ When a claim is at the hearing level, the claimant, or 
representative, generally must inform us about or submit all written 
evidence no later than five business days before the date of the 
scheduled hearing.\3\
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    \1\ 20 CFR 404.1512 and 416.912.
    \2\ 20 CFR 404.1740(b)(1) and 416.1540(b)(1).
    \3\ 20 CFR 404.935 and 416.1435.
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    Although 5 U.S.C. 552(a)(1) and (a)(2) do not require us to publish 
this SSR, we are doing so under 20 CFR 402.35(b)(1). SSRs do not have 
the same force and effect as statutes or regulations, but they are 
binding on all components of the Social Security Administration. 20 CFR 
402.35(b)(1).
    This SSR will remain in effect until we publish a notice in the 
Federal Register that rescinds it, or we publish a new SSR that 
replaces or modifies it.

(Catalog of Federal Domestic Assistance, Program Nos. 96.001, Social 
Security--Disability Insurance; 96.002, Social Security--Retirement 
Insurance; 96.004--Social Security--Survivors Insurance; 96.006 
Supplemental Security Income.)

Andrew Saul,
Commissioner of Social Security.

Policy Interpretation Ruling

SSR 19-3p: Titles II and XVI: Requesting Reconsideration or Hearing by 
an Administrative Law Judge

    Purpose: The purpose of this SSR is to explain the two options 
available to claimants appealing our determinations that they are not 
disabled based on medical factors. This SSR explains both the paper and 
electronic options for requesting reconsideration or a hearing by an 
ALJ, and the similarities and differences between these two options. In 
order to request reconsideration or a hearing using iAppeals, our 
electronic appeal option, claimants must submit all of the information 
we need to process their appeals at the time they file their electronic 
appeals. This requirement is part of our streamlined electronic appeal 
procedures. Claimants also can upload and simultaneously submit 
evidence with their electronic appeals. After claimants have filed 
their appeals, they can submit evidence by fax, by mail, or in-person 
at one of our field offices or hearing offices as appropriate.
    A claimant has an ongoing duty to inform us about or submit all 
known evidence that relates to whether or not he or she is blind or 
disabled.\4\ An appointed representative must act with reasonable 
promptness to help obtain the information and evidence the claimant 
must submit, and forward the information or evidence to us as soon as 
practicable.\5\ When a claim is at the hearing level, the claimant, or 
representative, generally must inform us about or submit all written 
evidence no later than five business days before the date of the 
scheduled hearing.\6\ Our paper appeal procedures remain unchanged--a 
claimant still must timely request his or her appeal in writing, but 
may separately submit the additional information we need to process the 
appeal. Through this SSR, we are providing information that enables 
claimants to make informed decisions when deciding whether to use 
iAppeals or the paper appeal option to request reconsideration or a 
hearing.
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    \4\ 20 CFR 404.1512 and 416.912.
    \5\ 20 CFR 404.1740(b)(1) and 416.1540(b)(1).
    \6\ 20 CFR 404.935 and 416.1435.
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    Citations: Sections 205(a) and (b) of the Social Security Act, as 
amended; 20 CFR 404.907, 404.909, 404.929, 404.933, 416.1407, 416.1409, 
416.1429, 416.1433.
    Introduction: Claimants who are dissatisfied with the 
determinations or decisions on their disability applications may 
request further review under our administrative review process, also 
known as our appeal process.\7\ The administrative review process 
consists of three levels: Reconsideration, hearing, and Appeals Council 
review. Until recent years, the only way for claimants to request an 
appeal was to use the paper-based option, which consists of paper 
appeal forms. As part of our efforts to offer alternative service 
delivery options to

[[Page 40468]]

the public, we developed an electronic appeals system, which we call 
iAppeals.\8\ After we implemented the iAppeals process, we received 
some questions about it, and how it differed from the traditional, 
paper-based process. This SSR explains the differences between the 
paper and electronic appeal procedures for filing a request for 
reconsideration or a hearing.\9\ Claimants have the option of filing a 
request for reconsideration or a hearing using either the paper-based 
option or iAppeals.
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    \7\ Section 205(b) of the Social Security Act (Act), 42 U.S.C. 
405(b); 20 CFR 404.900, 404.907, 404.909, 404.929, 404.933, 404.967, 
404.968, 416.1400, 416.1407, 416.1409, 416.1429, 416.1433, 416.1467, 
416.1468. See, e.g., Program Operations Manual System (POMS) GN 
03101.125 iAppeals--General and Title II Instructions; DI 81007.050 
i3441 Disability Appeal--iAppeals; SI 04005.035 iAppeals--Title XVI.
    \8\ Social Security Ruling (SSR) 96-10p ``Policy Interpretation 
Ruling Electronic Service Delivery,'' explains that our electronic 
service delivery initiatives allow the public to conduct their 
business in ways that are convenient for them and efficient for both 
them and us.
    \9\ Claimants may request Appeals Council (AC) review of 
administrative hearing decisions by using the HA-520 ``Request for 
Review of Hearing Decision/Order,'' the electronic i520, or a 
separate written request filed at one of our offices or by mail. The 
differences explained in this SSR are between the paper and 
electronic requests for reconsideration or a hearing and do not 
apply to the paper and electronic requests for review by the AC 
because we do not need the same type of information when processing 
requests for review by the AC.
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    Policy Interpretation: The Act states that a claimant may request 
an appeal by making ``a showing in writing.'' \10\ Our regulations 
provide that a claimant who seeks reconsideration or a hearing may do 
so by filing a ``written request'' within 60 days after receiving 
notice of our determination.\11\ These regulations give us the 
authority to establish mechanisms by which a claimant can file the 
``written request'' to appeal a determination. Accordingly, we have 
determined that a claimant may file a ``written request'' for appeal 
using either the paper-based appeals process or iAppeals.\12\ While 
there are some differences between our paper and electronic appeal 
options for filing a request for reconsideration or a hearing, the 
substantive standards used to evaluate a claimant's appeal request 
remain the same regardless of which option the claimant chooses.
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    \10\ 42 U.S.C. 405(b)(1) and 1383(c)(1).
    \11\ 20 CFR 404.909, 404.933, 416.1409, 416.1433.
    \12\ ``[T]echnologies allow the transfer of information by other 
than traditional paper-based methods. SSA is adopting a definition 
of writing which is consistent with modern legal usage and includes 
electronic information transfer.'' SSR 96-10p.
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The Paper-Based Process for Requesting a Reconsideration or a Hearing

    A claimant may file a written request for reconsideration or a 
hearing by either mail or in-person at one of our field offices. While 
our rules do not require claimants to use a specific form to request an 
appeal, the SSA-561 ``Request for Reconsideration'' (OMB No. 0960-0622) 
and HA-501 ``Request for Hearing by Administrative Law Judge'' (OMB No. 
0960-0269) collect basic information we need to process the appeal. The 
SSA-561 and HA-501 request specific identifying information, such as 
the claimant's name, Social Security number, date of birth, and contact 
information. The forms also request the name and contact information 
for any representative helping the claimant with the appeal, as well as 
the reason the claimant disagrees with the determination. The HA-501 
includes space for the claimant to identify sources who can provide 
additional evidence.
    Generally, a claimant also completes and submits the SSA-3441-BK 
``Disability Report--Appeal'' (OMB No. 0960-0144) along with the appeal 
request. The SSA-3441-BK collects updated information relevant to a 
claimant's appeal, including:
     The contact information of a friend or relative with 
knowledge of the claimant's medical condition;
     A description of any change to the claimant's medical 
condition and any new medical conditions;
     The contact information of and visit dates to all health 
care providers, and type of treatments, and tests received;
     The name of any medications (prescription or over-the-
counter) that the claimant is currently taking, the reasons for taking 
them, any side effects, and the name of the doctor who recommended or 
prescribed the medication; and
     A description of any change in daily activities, work, and 
education.
    While claimants do not have to submit the SSA-3441-BK at the time 
they file their paper appeal requests, a delay in providing the 
information requested on the SSA-3441-BK impedes our ability to process 
and forward an appeal request to the Disability Determination Services 
(DDS) for a reconsideration determination or to the Office of Hearings 
Operations for a decision by an ALJ. If a claimant does not provide the 
information requested on the SSA-3441-BK at the time he or she files 
the appeal request, generally, we attempt to contact the claimant in 
order to obtain the information before the DDS makes a determination or 
an ALJ makes a decision.\13\
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    \13\ POMS DI 12005.005--Processing a Reconsideration Request for 
a Medically Denied Initial Disability Claim; DI 12010.001--Request 
for Administrative Law Judge (ALJ) Hearing; DI 12010.005--
Development of Administrative Law Judge (ALJ) Hearing Cases.
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The iAppeals Process for Requesting Reconsideration or a Hearing

    A claimant may file a written request for reconsideration or a 
hearing using iAppeals, our electronic appeal option.\14\ When we first 
introduced iAppeals in 2007, claimants could submit the electronic 
disability report form, i3441, ``Disability Report--Appeal,'' after 
filing the i561, ``Request for Reconsideration,'' or i501, ``Request 
for Hearing by Administrative Law Judge.'' In 2015, we streamlined 
iAppeals by merging questions from the standard appeal request forms, 
i561 or i501, and the disability report, i3441, form, so that all of 
the information needed to process an appeal is collected and submitted 
at the same time.
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    \14\ Appointed representatives, as well as family and friends, 
are permitted to use iAppeals to file appeals on behalf of a 
claimant. An appointed representative seeking direct payment of his 
or her fee for services performed on the claim has an affirmative 
duty to use iAppeals. See 20 CFR 404.1713, 404.1740, 416.1513, 
416.1740; 77 FR 4653; POMS GN 03970.010B.4. This affirmative duty is 
only for the appointed representative, not the claimant.
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    Claimants who choose to use iAppeals to request an appeal must 
complete the full electronic appeal application in order to file the 
appeal electronically. Completing the full electronic appeal 
application requires claimants to answer questions from both the 
standard appeal request form and the disability report form. However, 
iAppeals offers several flexibilities for claimants: Permitting 
claimants to leave questions blank if they are not applicable; allowing 
claimants to indicate that they need additional time to collect 
specific evidence; and enabling claimants to partially complete an 
electronic appeal application, save it, and return to finish it later, 
so long as they return and submit the appeal within the regulatory 
appeal period. Claimants must file their appeals, whether using the 
paper or the electronic administrative appeals process, within the 60-
day appeal period.\15\
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    \15\ Claimants must complete and submit their appeals within 60 
days of receiving the notice of determination they are appealing. 
Claimants who do not submit their appeals within the applicable 60-
day period may request an extension of time. See 20 CFR 404.909, 
404.911, 404.933, 416.1409, 416.1411, 416.1433. Claimants may 
request an extension of time on paper or using iAppeals. If a 
claimant files an untimely appeal via paper or using iAppeals, but 
does not provide reasons for why the appeal is untimely, we will 
request a good cause statement before determining whether to process 
or dismiss the appeal. See POMS GN 03101.010A.2, GN 03101.020, SI 
04005.012B, SI 04005.015.
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    To ensure that claimants understand the requirements for using the 
electronic appeal procedures to request reconsideration or a hearing, 
we have

[[Page 40469]]

included the following aids in the iAppeals screen path to assists 
them:
     Terms of Service (TOS) Screen--The TOS provides 
information about the types of appeals that claimants can file in 
iAppeals, information needed to complete an electronic appeal, and the 
alternative option to file an appeal request by mail or in-person at 
the local Social Security Office. The Acknowledgement portion of the 
TOS requires the claimant or a third party on the claimant's behalf to 
acknowledge that he or she understands certain information, including:
    [cir] The electronic appeal must be completed and filed within the 
60-day appeal period.
    [cir] The ``Submit'' button within the ``Submit'' Tab must be 
selected to file the appeal request with the Social Security 
Administration.
    [cir] How to submit evidence, both before and after the appeal is 
filed.
    [cir] When he or she can and cannot re-enter the iAppeals 
application.
    [cir] How to ensure that the electronic appeal is properly 
submitted.
    [cir] How to add additional information or change information that 
has already been submitted.
     Re-entry Number Screen--Claimants who choose not to 
complete their electronic appeals in one session can use the re-entry 
number we provide to return to iAppeals to complete and submit their 
appeals in subsequent sessions. The re-entry number screen explains 
that the appeal has not been completed or submitted and that claimants 
who choose to exit iAppeals before completion must return to iAppeals 
in order to complete and submit their appeals electronically.
     Submit Tab: Claimants will see the Submit Tab throughout 
the electronic appeal application path. The Submit Tab remains 
available to select until claimants complete and submit their 
electronic appeal. The Submit Tab will not be available once the 
electronic appeal is submitted.

Conclusion

    iAppeals is an efficient and convenient self-service option that 
allows claimants who are dissatisfied with our determination to 
electronically complete and submit a request for reconsideration or a 
hearing. The paper-based administrative appeals process remains 
available for claimants who wish to use it. While the use of iAppeals 
promotes our ability to process cases faster, it is the claimant's 
choice whether to use the paper or electronic administrative appeals 
process. Claimants can obtain more information about iAppeals and our 
paper appeal process by visiting our website www.ssa.gov. Claimants can 
find information about the iAppeals user experience in our Program 
Operations Manual System at https://secure.ssa.gov/apps10/poms.nsf/lnx/0203101125.
[FR Doc. 2019-17359 Filed 8-13-19; 8:45 am]
 BILLING CODE 4191-02-P